title: Autoimmune retinopathy.
abstract: OBJECTIVE
  Autoimmune retinopathy (AIR) is an immune-mediated disorder characterized by progressive visual loss, abnormal electroretinographic and visual field findings in the presence of circulating anti-retinal antibodies. This review highlights advances made toward understanding the pathophysiology, clinical manifestations, and trends in the management of AIR.
  
  
  RESULTS
  The pathophysiology of AIR is likely antibody-mediated. AIR serum autoantibodies are variable in their size and retinal tissue they target and can also be present in healthy controls and multiple autoimmune diseases. Rarely, AIR may be associated with dysregulated self-tolerance mechanisms in the thymus. Despite progress in research, our understanding of AIR remains incomplete. Lack of standardized methods for anti-retinal antibody testing continues to challenge the interpretation of seropositivity. Conventional immunosuppressives have been further studied, and promising immunomodulatory therapies, such as targeted B-cell therapy, have been introduced. Newer imaging modalities such as fundus autofluorescence and spectral domain optical coherence tomography may be helpful in diagnosis, monitoring progression of disease and response to treatment.
  
  
  CONCLUSIONS
  AIR is a rare but vision-threatening disease whose pathogenesis is poorly defined. Lack of standardized clinical or laboratory criteria further complicates the diagnosis and management. Despite recent progress, further basic science research into the autoimmune process is needed. Prospective controlled clinical trials with immunomodulatory therapy can help define future treatment paradigms.
authors.affiliation: National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Didar U
authors.initials: DU
authors.lastname: Comlekoglu
authors.forename: Ian A
authors.initials: IA
authors.lastname: Thompson
authors.forename: H Nida
authors.initials: HN
authors.lastname: Sen
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000276:immunology; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D006801:Humans; D012160:Retina / Q000276:immunology*; D012164:Retinal Diseases / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy
chemical_list: D001323:Autoantibodies; D001324:Autoantigens